Provider Demographics
NPI:1104972959
Name:KNAPP, CRAIG W (PHD)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:W
Last Name:KNAPP
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 218
Mailing Address - Street 2:646 N. SHREWSBURY ROAD
Mailing Address - City:N CLARENDON
Mailing Address - State:VT
Mailing Address - Zip Code:05759-0218
Mailing Address - Country:US
Mailing Address - Phone:802-775-2728
Mailing Address - Fax:
Practice Address - Street 1:646 N. SHREWSBURY ROAD
Practice Address - Street 2:
Practice Address - City:N CLARENDON
Practice Address - State:VT
Practice Address - Zip Code:05759-0218
Practice Address - Country:US
Practice Address - Phone:802-775-2728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT261103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist